FLEMING ISLAND – Florida Republicans are aiming to remove a key regulation in the process to build hospitals.

To build a hospital, health companies have to apply for a Certificate of Need in which they must prove a community’s population could sustain a hospital and gain approval from hospitals in the area before constructing a new facility.

Sen. Rob Bradley (R-Fleming Island) has filed the bill to eliminate the CON, with a companion bill sponsored in the House of Representatives by Rep. Alex Miller (R-Sarasota). Bradley said he hoped the bill would result in more choices for Clay County residents due to the increase in competition.

“Baptist in the past has expressed interest. I would love to see every family in Clay County have a variety of choices to meet their healthcare needs. Competition makes everybody better. It drives down prices and it increases quality,” Bradley said.

Bradley said he values a free market approach to healthcare which was also expressed by Gov. Rick Scott. Bradley said the CON would be replaced with a licensure process and there will still be quality standards hospitals have to meet.

“The states have a role to play when we redesign healthcare, to create for access and affordability for consumers,” Bradley said “I believe this bill adds a more free market approach to delivery of services offered by hospitals.”

Certificates of Need regulations were federally mandated in 1972, though they have been rolled back in several states and repealed completely in 14. A bill to eliminate Florida’s CON was shot down in the Senate last year.

Baptist Health applied to build hospital on Fleming Island twice in the past 10 years, but they were denied both times. However, Baptist Health Chief Executive Officer Hugh Greene wanted the CON law to stay in place. Greene said repealing the law would generate an “arms race” between hospitals in areas where there might not necessarily be a need. Greene said that even though a removal of the CON would enable Baptist Health to build a hospital in Clay County, there are long term consequences of changing the law.

“When you’re talking about hospitals, you’re talking about a major 50-year heavy investment, and to let those build in a non-planned, non-need driven way concerns me,” Greene said.

Greene said he a few of the current CON restrictions could be stricken. Currently, a company can only build a new hospital within a mile of an older aging facility. Greene favored a limit on how long an existing hospital can delay another hospital from acquiring a CON. Under current regulations, Greene said, the process may take years.

Health consultant John Lynch has 35 years of experience with CONs in Massachusetts, which are roughly similar to Florida’s CON law. He said treating healthcare as a free market is a slippery slope.

“The whole free market argument hinges on the premise that healthcare is a normal marketplace with willing and able consumers that are controlling their own purchasing decisions,” Lynch said. “But that’s not really true in healthcare.”

Lynch said most healthcare decisions aren’t made by the patients, they’re made by the doctors. They go where a doctor has admitting privileges, they don’t necessarily choose the hospital they go to.

Removing the CON would hurt hospitals that have unprofitable services such as emergency room and psychiatry services, Lynch said, because specialty healthcare providers may cherry-pick profitable services such as imaging and surgery centers.

On Feb. 15, the bill passed in a House Health Innovation Subcommittee 11-5 on party lines. The bill faces its next test in the Health Care Appropriations Subcommittee.

The Florida Legislature convenes March 7.